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r\ This is a True Copy of Certificate Originaly Issued ------------ Ne11CYandWo W---------------------- Director of Assistance DEPARTMENT NEBRASKA BOARD OF CONTROL OF ASSISTANCE AND CHILD WELFARE N° 13 DECLARATION OF OWNERSHIP OF REAL ESTATE M Old Age Assistance ❑ Blind Assistance _.4rand- Is].and-................... --.................. -------------- ----- ----------I-------------------foy .9----------- .......................... 19...._'9.._ City or Village ------------------------------------ Hall.-----------------------................--.................... ---- - -------------- --.....---------._6. 368--------------------------------------------------------- ----- --------------- County Application Number In compliance with State Assistance Statutes in Section 68 Comp. St. Supp. 1937, 1 hereby declare the following described real estate as all of the real estate owned in whole or in part by myself and/or my spouse. 1. Legal description of real estate used by me as place of my residence: Lots 24,25,26,& 27;Bark's Subdivision No.2 2. Legal description of all real estate not used by me as place of my residence: the aska ay 12, pursuant to the Enactment of L. B. 89, by o release 6 he th Session oAgef A sistae Legislature liens of reco state her by Dof r releasers th�aPP *��Ttth n 1 en this 1941, authorising t >� .. ..)!'.'� ! ' .......... .. �!... day of ....... . . �i...., 1941. ' ' Register of Deeds ..................... Anthony Signed.....-----------------Jeimee..._Oeraey ................................... -- . Witness Applicant for Assistance VERIFICATION have investigated the .......- .....................x .Z ----........................................... County records and hereby certify the above description(s) to be correct to the best of my knowledge. ....................... -..... -............... ------Mur.. el.-- Antbo air.._..---------.....---------- .......... County 04MW Visitor To: State Assistance Director, �v---._.--.--.....County 1008 State Capitol, Lincoln, Nebraska ------------------------ .-_---------.19-1-1------ Received for record Certificate of Award for Application No ............ $--. ._.._..36 ..-..-.............-..-.... (Old Age Assistance), (Blind Assist- ance) at. ........ 9.........................o'clock and ........................... minutes ...-.l.M. in compliance with Sec. 68-258 Comp. St. Supp., 1937 as amended by L. B. 389, 53rd Session Nebraska Legislature, or 68-413 Com. St. Supp., 1939. Book 1,Page 13 Signed ---------- -- ---------......---- -- ----------- Register of Deeds TM.K..I�.[[0. YYo �i4xC� WM1.